newly diagnosed Gleason 6 65 years old

SubDenis
SubDenis Member Posts: 130

Hello all, I was diagnosed 2 days ago with prostate cancer.  I am in the confused, shocked mode.  I am looking for reading material to help me discern treatment options.  Thanks, Denis

«13

Comments

  • Rakendra
    Rakendra Member Posts: 197 Member
    edited July 2017 #2
    Good Luck

    Dennis, welcome to the board, and sorry that you have to be here.  You might share more information so that the guys can help you, and everybody is in shock and confused in the begining.  The good news is that almost always Pca is much less of a problem than what we first thought.  As far as treatment goes, there is a fountain of information here on this board from guys who have done that.   We will need a lot more information, but in the meantime go thru the board and read the posts that are closest to your case.  Good luck.  Love, Swami

  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,333 Member
    In order for us to help you

    In order for us to help you with information, you need to let us know your history, that is what led to a biopsy; PSA history, any thing felt from the digital rectal exam (figer wave), how many cores were taken in the biopsy, how many were positve, of those that were positive what was the percent involvement (how much) of   each core that was positive, any other finding from the biopsy. Any other diagnostic tests?

    In many cases with a Gleason 6 ,  Active Surveillance only is the preferred treatment, that is no active treatment until needed (which can be a lifetime). I for one have been doing AS for nine years at this date.

    Get back to us

  • ASAdvocate
    ASAdvocate Member Posts: 180 Member
    Can you provide us with more

    Can you provide us with more details from the biopsy pathology report? How many cores were taken? How many were positive? Where they all on one side, or both? What was the percentage of cancer in those cores?  What is your psa? have you had an MRI?

    The NCCN standard for most Gleason (3+3) is active surveillance, which is no immediate treatment, but regular follow-up monitoring. I have been on AS for eight years, and hope to die of something else without ever needing to treat my prosate cancer.

     

  • SubDenis
    SubDenis Member Posts: 130

    In order for us to help you

    In order for us to help you with information, you need to let us know your history, that is what led to a biopsy; PSA history, any thing felt from the digital rectal exam (figer wave), how many cores were taken in the biopsy, how many were positve, of those that were positive what was the percent involvement (how much) of   each core that was positive, any other finding from the biopsy. Any other diagnostic tests?

    In many cases with a Gleason 6 ,  Active Surveillance only is the preferred treatment, that is no active treatment until needed (which can be a lifetime). I for one have been doing AS for nine years at this date.

    Get back to us

    I have had a couple of years

    I have had a couple of years of PSA low 4s, this last year it went to 4.7.  A physical exam should enlarge but smooth prostate.  Mri should areas of concern on one side. Needle biopsy, 13 cores, showed four with cancer left and right side.  Biggest was 5mm.  All Gleason 3+3.

    I think the stage is considered 1c.

    I am a bit in the overwhelmed stage, trying to figure out how to decide on treatment.  Active surveillance seems the right course for year one while I get educated and find more info. 

    I really want to find someone(s) to talk holistically.  The surgeon talks cutting, I meet with oncologist Tuesday and I am sure their focus will be radiation. I have one friend who has bladder cancer and he is going to cancer center of America and loving their approach. 

    Feeling a bit lost. 

    Thanks, Denis

  • SubDenis
    SubDenis Member Posts: 130
    edited July 2017 #6

    Can you provide us with more

    Can you provide us with more details from the biopsy pathology report? How many cores were taken? How many were positive? Where they all on one side, or both? What was the percentage of cancer in those cores?  What is your psa? have you had an MRI?

    The NCCN standard for most Gleason (3+3) is active surveillance, which is no immediate treatment, but regular follow-up monitoring. I have been on AS for eight years, and hope to die of something else without ever needing to treat my prosate cancer.

     

    Thanks, I am surely going to

    Thanks, I am surely going to using AS for at least a year.  Studies seem to suggest that at my stage, see prior post, there is no harm waiting a year. Still wrestling with the thought that I have cancer. Appreciate your hopeful post!  

    Thanks, Denis

  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,333 Member
    edited July 2017 #7
    SubDenis

    All of us who are diagnosed experience shock and all those negative feelings. This includes those like you who have been diagnosed with low aggressive, low volume disease who are ideal candidates for Active Surveillance. This shock usually last a few months.

     

    Be aware that many do not consider those who have been diagnosed with low volume Gleason 6 as you have been,  to have cancer. In fact studies have shown that there is no metasis with with those who only have Gleason 6. Here is a very recent presentation that this discuss this, plus other issues of Active Surveillance.  Dr. Laurende Klotz of Toronto Canada is the pre-eminent expert on Active Surviellance. Here is a very recent presentation that he has done that lasts about 45 minutes that you,  ASAdvocate and others with interest will find worthwhile to view.

    https://www.urotoday.com/video-lectures/advanced-prostate-cancer/video/mediaitem/778-embedded-media2017-06-02-13-54-01.html?utm_source=newsletter_4652&utm_medium=email&utm_campaign=uroalerts-prostate-cancer-weekly

    There are institutions that specialize in monitoring those with with low risk disease, who pursue AS, so it is important for you to interview with one of these. There is new technology that  is now available where the patient first has a multiparametric MRI, a radiologist ranks any suspicous lesions found, and then a biopsy is given using three dimensional capability to target the MRI lesions found. One manufacturer of these biopsy machines is "Artemis". More confidence can be placed on the results of this technology than the standard random biopsy done in the local doctors office. Additionally, with the advanced technology the doctor can go back to the exact area of the prostate that is of concern.

    if you click my name to the left, you will see exactly what diagnostic tests i have done, and the results. Additionally I have listed details of various tests that are available, and information about AS

    Best

    H

    PS You mention that you are considering AS for a year, why not a life time, and not be subjected to the possible side effects of the various Active treatments that are available....these side effects can be life changing and even cause death in some occassions.

  • Mulhaley
    Mulhaley Member Posts: 12 Member
    SubDenis said:

    I have had a couple of years

    I have had a couple of years of PSA low 4s, this last year it went to 4.7.  A physical exam should enlarge but smooth prostate.  Mri should areas of concern on one side. Needle biopsy, 13 cores, showed four with cancer left and right side.  Biggest was 5mm.  All Gleason 3+3.

    I think the stage is considered 1c.

    I am a bit in the overwhelmed stage, trying to figure out how to decide on treatment.  Active surveillance seems the right course for year one while I get educated and find more info. 

    I really want to find someone(s) to talk holistically.  The surgeon talks cutting, I meet with oncologist Tuesday and I am sure their focus will be radiation. I have one friend who has bladder cancer and he is going to cancer center of America and loving their approach. 

    Feeling a bit lost. 

    Thanks, Denis

    Just a note on my recent experience

    For what it's worth: I am 61, diagnosed early this year with adenocarcinoma in my prostate, Gleason 4+3, PSA 6.3 when I went ahead with the MRI and biopsy last March.  It had been climbing slowly for about 5 years or so.  I chose LDR brachytherapy (radioactive seed implant) followed by 35 sessions of external beam radiation at the Radiotherapy Clinics of Georgia, which just happens to be a short drive from my home near Atlanta.  I finished up treatment this past Friday.  I have to say I am well pleased by the lack of troublesome side effects at this point--I have no major problem with incontinence, meaning I can hold my urine, though there is sometimes minor leakage following urination (that's been true to some extent for years anyway), no bowel problems, no burning or pain on urination, and no trouble with emptying my bladder when I need to.  I do have increased frequency of urination, and a somewhat weaker stream.  I have a degree of ED, but that was true before all this happened---I have been under a cardiologist's care for twenty years, and have type 2 diabetes as well, so in that department there was trouble anyway.  It may be a bit worse now, but I am not surprised by that.  I had some fatigue which kicked in at around 4 weeks of external radiation, but it wasn't debilitating.   If you are still reasearching options, I would recommend you at least speak to someone at RCOG about their ProstRcision program.  My first post-treatment PSA test will be in a couple of weeks, and of course the efficacy of treatment is what it's all about, so I don't have that information yet, but their track record is apparently pretty good, according to the data they report.  I've spoken to a few guys who went through the program ten and more years ago, and they are satisfied with their results.    The lowest PSA level after radiation is expected after 18 to 24 months, so I will be monitored frequently for the next few years.  I was very well treated by my radiation oncologist and the staff.  Hoping for the best, and hoping for the best for you and all the folks here on the board.   Their website is  http://www.prostrcision.com/ 

     

     

  • SubDenis
    SubDenis Member Posts: 130
    Mulhaley said:

    Just a note on my recent experience

    For what it's worth: I am 61, diagnosed early this year with adenocarcinoma in my prostate, Gleason 4+3, PSA 6.3 when I went ahead with the MRI and biopsy last March.  It had been climbing slowly for about 5 years or so.  I chose LDR brachytherapy (radioactive seed implant) followed by 35 sessions of external beam radiation at the Radiotherapy Clinics of Georgia, which just happens to be a short drive from my home near Atlanta.  I finished up treatment this past Friday.  I have to say I am well pleased by the lack of troublesome side effects at this point--I have no major problem with incontinence, meaning I can hold my urine, though there is sometimes minor leakage following urination (that's been true to some extent for years anyway), no bowel problems, no burning or pain on urination, and no trouble with emptying my bladder when I need to.  I do have increased frequency of urination, and a somewhat weaker stream.  I have a degree of ED, but that was true before all this happened---I have been under a cardiologist's care for twenty years, and have type 2 diabetes as well, so in that department there was trouble anyway.  It may be a bit worse now, but I am not surprised by that.  I had some fatigue which kicked in at around 4 weeks of external radiation, but it wasn't debilitating.   If you are still reasearching options, I would recommend you at least speak to someone at RCOG about their ProstRcision program.  My first post-treatment PSA test will be in a couple of weeks, and of course the efficacy of treatment is what it's all about, so I don't have that information yet, but their track record is apparently pretty good, according to the data they report.  I've spoken to a few guys who went through the program ten and more years ago, and they are satisfied with their results.    The lowest PSA level after radiation is expected after 18 to 24 months, so I will be monitored frequently for the next few years.  I was very well treated by my radiation oncologist and the staff.  Hoping for the best, and hoping for the best for you and all the folks here on the board.   Their website is  http://www.prostrcision.com/ 

     

     

    Thanks for sharing your

    Thanks for sharing your journey.  I get hope from your story.  I definitely will add your referral to the decision tree.  I wish you a speedy recovery. Thanks, Denis

  • SubDenis
    SubDenis Member Posts: 130
    edited July 2017 #10

    SubDenis

    All of us who are diagnosed experience shock and all those negative feelings. This includes those like you who have been diagnosed with low aggressive, low volume disease who are ideal candidates for Active Surveillance. This shock usually last a few months.

     

    Be aware that many do not consider those who have been diagnosed with low volume Gleason 6 as you have been,  to have cancer. In fact studies have shown that there is no metasis with with those who only have Gleason 6. Here is a very recent presentation that this discuss this, plus other issues of Active Surveillance.  Dr. Laurende Klotz of Toronto Canada is the pre-eminent expert on Active Surviellance. Here is a very recent presentation that he has done that lasts about 45 minutes that you,  ASAdvocate and others with interest will find worthwhile to view.

    https://www.urotoday.com/video-lectures/advanced-prostate-cancer/video/mediaitem/778-embedded-media2017-06-02-13-54-01.html?utm_source=newsletter_4652&utm_medium=email&utm_campaign=uroalerts-prostate-cancer-weekly

    There are institutions that specialize in monitoring those with with low risk disease, who pursue AS, so it is important for you to interview with one of these. There is new technology that  is now available where the patient first has a multiparametric MRI, a radiologist ranks any suspicous lesions found, and then a biopsy is given using three dimensional capability to target the MRI lesions found. One manufacturer of these biopsy machines is "Artemis". More confidence can be placed on the results of this technology than the standard random biopsy done in the local doctors office. Additionally, with the advanced technology the doctor can go back to the exact area of the prostate that is of concern.

    if you click my name to the left, you will see exactly what diagnostic tests i have done, and the results. Additionally I have listed details of various tests that are available, and information about AS

    Best

    H

    PS You mention that you are considering AS for a year, why not a life time, and not be subjected to the possible side effects of the various Active treatments that are available....these side effects can be life changing and even cause death in some occassions.

    Thanks for your note and

    Thanks for your note and words of encouragement.  I definitely will investigate your suggestions.  I say a year because I am in the infant stage of understanding whats going on, less than a week since the doc said I have cancer.  I know there is great research and that there are still many unknowns about this disease.  I believe the one thing I can control is to educate myself.  Thanks for your hope! Denis

  • VascodaGama
    VascodaGama Member Posts: 3,513 Member
    edited July 2017 #11
    What's your Clinical Stage

    Denis,

    I think you doing well in considering AS as your starter. It will give you time to read the rest of the menu, becoming acquainted with PCa condiments and treatment spices, and then; decide in an option. You seem to be interested in an holistically aproach for caring the issue but I hope that you do not mean to start taking snake-oil like therapies in the hope of solving the problem. Restrictions in diet help in preventing worse issues but do not cure. You can find many supplements on supermarket's shelves invoking high benefits without any truthfully verified result. Some were found to include substances in the mixture that are in fact used in hormonal treatments for prostate cancer but much more expensive. 

    Your next move should include the means to verify the data already collected that will serve you with the best diagnosis (your real present status). In your next consultation ask for a clinical stage. The biopsy sets you with T1c (positive for cancer). This easily can be pushed up to a T2c (depending on which doctor is doing the digital rectum examination, DRE), as you got tumours in both lobes. Surely your shared info seems to refer to a low risk, not voluminous case that is contained and probably proper for AS. 

    I recommend you to advance researching and that you involve your family in the decisions. PCa affects everyone even your children that share the same genes. Boys and girls are at risk 4 to contract prostate and/or breast cancer.
    As many commented above, PCa makes us anxious in the beginning because we are dealing with the unknown. Many think in death but in comparison with other cancers, prostate cancer is considered a slow growing cancer (five times lesser than breast cancer) that provides means and time to the patient for educating on the matter. I would recommend you to read some books (latest editions), including treatments in case you opt for a radical;

    Active Surveillance for Localized Prostate Cancer: A New Paradigm for Clinical Management, by Laurence Klotz;

    Prostate Book, by Dr. Peter Scardino, SKCC;

    Guide to Surviving Prostate Cancer, by Dr. Patrick Walsh, Johns Hopkins; 

    A compendium on Prostate cancer and care;

    http://www.lef.org/Protocols/Cancer/Prostate-Cancer-Prevention/Page-01

    Ideas for a List of Questions to help in consultation

    http://www.cancer.org/cancer/prostatecancer/detailedguide/prostate-cancer-talking-with-doctor

    http://www.cancer.net/patient/All+About+Cancer/Newly+Diagnosed/Questions+to+Ask+the+Doctor

    My guess opinion on your comment about the constant high PSA level ( 4.0 to 4.7 ng/ml) in the last three years, is that you have no hyperplasia, meaning that the serum is a cause solo of the cancer, with a long doubling (non aggressive). I wonder about the location of the positive cores. Can you provide the contents of the pathologist's report?

    Best wishes and luck in your journey.

    VGama

     

     

     

     

     

  • Max Former Hodgkins Stage 3
    Max Former Hodgkins Stage 3 Member Posts: 3,736 Member
    SubDenis said:

    I have had a couple of years

    I have had a couple of years of PSA low 4s, this last year it went to 4.7.  A physical exam should enlarge but smooth prostate.  Mri should areas of concern on one side. Needle biopsy, 13 cores, showed four with cancer left and right side.  Biggest was 5mm.  All Gleason 3+3.

    I think the stage is considered 1c.

    I am a bit in the overwhelmed stage, trying to figure out how to decide on treatment.  Active surveillance seems the right course for year one while I get educated and find more info. 

    I really want to find someone(s) to talk holistically.  The surgeon talks cutting, I meet with oncologist Tuesday and I am sure their focus will be radiation. I have one friend who has bladder cancer and he is going to cancer center of America and loving their approach. 

    Feeling a bit lost. 

    Thanks, Denis

    Generalities

    Welcome, Denis

    I will just at random comment on a few of the variables that the other guys have already discussed. 

    1. It is possible that you are Stage 1t, but that is far from established yet.   I was believed to be t1 when diagnosed, but the pathology study of the gland showed two months after the biopsy, when I had surgery, to be a fairly well-involved t2 instead.  I also was a Gleason 6, and had only 1 core positive in a 12-core biopsy.  I never had I had a PSA  over 4.2, but had a significant vector, or doubling rate: the numbers went up every year, never remained the same. Every DRE was completely normal -- the doctors could feel nothing abnormal "from the rear" of the gland. ;)   A DRE only provides information regarding the part of the gland adjacent to the rectum, obviously; it gives no information regarding the other surfaces of the gland. But it can also tell an experienced urologist a lot about the approximate size of the gland.   The tendency in biopsies, if they are not completely accurate, is to UNDERESTIMATE staging, not overestimate it.  That is, false negatives are much more common than false positiives. But this is a generality, and anything is possible.

    2. My urologist told me straight away that I was a good candidate for A/S, at 58 years of age.  I knew I would not be comfortable with A/S and chose to proceed with surgery after meeting with a radiation oncologist first, and speaking with my medical oncologist who treated me in 2010 for Hodgkin's Lymphoma (Lymphoma is totally unrelated to PCa -- totally different cells and malignancy.)

    3. You mentioned Cancer Treatment (?) Centers of America.  They overall have a fairly good reputation, certainly very competent.  They are not a cutting edge provider; not a Sloan Kettering or MD Anderson or Cleveland Clinic by any stretch, but still a good choice in most cases.  I have heard (indirectly) that they have a personably style, which is lacking in many places.  Certainly convenience and rapport are important issues, and they have I beleive 5 regional hospitals around the US. 

    4. You apparantly have incipient, unaggressive disease.  PCa is usually very slow-moving.  You have time to take your time and research this calmly and systematically. Do not decide on a treatment option until you have had a variety of assessments from at least two or more doctors. And do not get "second opinions" from your first doctor's partner, who works in the cube adjacent to his, because that is really just the same opinion coming out of a different mouth, in many instances. Get your second opinions from doctors in different institutuions of practices.

    max

  • SubDenis
    SubDenis Member Posts: 130
    edited August 2017 #13

    What's your Clinical Stage

    Denis,

    I think you doing well in considering AS as your starter. It will give you time to read the rest of the menu, becoming acquainted with PCa condiments and treatment spices, and then; decide in an option. You seem to be interested in an holistically aproach for caring the issue but I hope that you do not mean to start taking snake-oil like therapies in the hope of solving the problem. Restrictions in diet help in preventing worse issues but do not cure. You can find many supplements on supermarket's shelves invoking high benefits without any truthfully verified result. Some were found to include substances in the mixture that are in fact used in hormonal treatments for prostate cancer but much more expensive. 

    Your next move should include the means to verify the data already collected that will serve you with the best diagnosis (your real present status). In your next consultation ask for a clinical stage. The biopsy sets you with T1c (positive for cancer). This easily can be pushed up to a T2c (depending on which doctor is doing the digital rectum examination, DRE), as you got tumours in both lobes. Surely your shared info seems to refer to a low risk, not voluminous case that is contained and probably proper for AS. 

    I recommend you to advance researching and that you involve your family in the decisions. PCa affects everyone even your children that share the same genes. Boys and girls are at risk 4 to contract prostate and/or breast cancer.
    As many commented above, PCa makes us anxious in the beginning because we are dealing with the unknown. Many think in death but in comparison with other cancers, prostate cancer is considered a slow growing cancer (five times lesser than breast cancer) that provides means and time to the patient for educating on the matter. I would recommend you to read some books (latest editions), including treatments in case you opt for a radical;

    Active Surveillance for Localized Prostate Cancer: A New Paradigm for Clinical Management, by Laurence Klotz;

    Prostate Book, by Dr. Peter Scardino, SKCC;

    Guide to Surviving Prostate Cancer, by Dr. Patrick Walsh, Johns Hopkins; 

    A compendium on Prostate cancer and care;

    http://www.lef.org/Protocols/Cancer/Prostate-Cancer-Prevention/Page-01

    Ideas for a List of Questions to help in consultation

    http://www.cancer.org/cancer/prostatecancer/detailedguide/prostate-cancer-talking-with-doctor

    http://www.cancer.net/patient/All+About+Cancer/Newly+Diagnosed/Questions+to+Ask+the+Doctor

    My guess opinion on your comment about the constant high PSA level ( 4.0 to 4.7 ng/ml) in the last three years, is that you have no hyperplasia, meaning that the serum is a cause solo of the cancer, with a long doubling (non aggressive). I wonder about the location of the positive cores. Can you provide the contents of the pathologist's report?

    Best wishes and luck in your journey.

    VGama

     

     

     

     

     

    Thanks for the well written

    Thanks for the well written and informative post.  Holistic to me is a well-balanced mind, body and spirit approach to health.  Nutrition, exercise, learning, and scientific based medicines and treatments. I am by trade an educator/researcher so I am on the learning path which includes reading, talking with knowledgeable folks, and seeking input from experienced folks like you.  

    My cores were left lateral base 5mm of 1.7cm or 29%; right base 3mm of 1.7cm or 18%; right lateral mid 1mm of 1.5 cm or 6% and the last one doesn't say location "pink lesion" two cores 4mm of 1.5cm or 27% also says "focal high-grade PIN noted. 

    I appreciate your reading sources and will digest them.  Some I already have.  Tomorrow I meet with the oncologist to understand treatment options. 

    Thanks, Denis

  • VascodaGama
    VascodaGama Member Posts: 3,513 Member
    Second opinion on biopsy slides

    Denis,

    From the last info you share above and due to your wish in pursuing AS, I would recommend you to investigate further the details of the biopsy, probably even getting a second opinion on the biopsy cores at a reliable laboratory, such as Johns Hopkins, Bostwick, etc. You can request your doctor to send the samples directly or just do it yourself by courier. Where do you live?

    My lay interpretation on the data is that the "Pink" cores refer to needle(s) taken from a lesion identified in an image study. It could have been from the MRI or from a collor Doppler used in an exam done before the biopsy or found during TRUS. The finding maybe commented/located in the MRI report (?). Another registered comment that deserves attention is the "focal high-grade PIN". This refers to the finding of abnormal cells that are judged not cancerous but that it may turn into cancer in the future.
    The cores found with high volume are at the base in both lobes (right and left) which area is close to the bladder (the bladder seats on the prostate base) and prune to invasion of the delicate sphincter. There is no indication of positive cores at the apex (closer to the colon) so that a negative DRE could be expected.

    I wonder if you had any urination issue? Tissues at the base (cancer) could have grown and be squeezing the urethra or the bladder wall which lead to urine retention/urgency. Can you share more details about your initial PSA tests and the reason for having them. What made you to do a biopsy? Any symptom?

    Here is a link regarding the second opinion;

    http://pathology.jhu.edu/department/services/secondopinion.cfm

    Please note that I am not a doctor. My comments are from many years of researching PCa issues since I become a survivor and as a continuing patient.

    Best wishes,

    VG

  • SubDenis
    SubDenis Member Posts: 130

    Second opinion on biopsy slides

    Denis,

    From the last info you share above and due to your wish in pursuing AS, I would recommend you to investigate further the details of the biopsy, probably even getting a second opinion on the biopsy cores at a reliable laboratory, such as Johns Hopkins, Bostwick, etc. You can request your doctor to send the samples directly or just do it yourself by courier. Where do you live?

    My lay interpretation on the data is that the "Pink" cores refer to needle(s) taken from a lesion identified in an image study. It could have been from the MRI or from a collor Doppler used in an exam done before the biopsy or found during TRUS. The finding maybe commented/located in the MRI report (?). Another registered comment that deserves attention is the "focal high-grade PIN". This refers to the finding of abnormal cells that are judged not cancerous but that it may turn into cancer in the future.
    The cores found with high volume are at the base in both lobes (right and left) which area is close to the bladder (the bladder seats on the prostate base) and prune to invasion of the delicate sphincter. There is no indication of positive cores at the apex (closer to the colon) so that a negative DRE could be expected.

    I wonder if you had any urination issue? Tissues at the base (cancer) could have grown and be squeezing the urethra or the bladder wall which lead to urine retention/urgency. Can you share more details about your initial PSA tests and the reason for having them. What made you to do a biopsy? Any symptom?

    Here is a link regarding the second opinion;

    http://pathology.jhu.edu/department/services/secondopinion.cfm

    Please note that I am not a doctor. My comments are from many years of researching PCa issues since I become a survivor and as a continuing patient.

    Best wishes,

    VG

    Thanks again for the

    Thanks again for the informative post.  My PSA has been hovering around 4 for a few years. Prostate exam indicated enlarged but smooth.  One year ago PSA was 4.1 and this year it was up to 4.6 or 7.  Urologist ordered high fidelity MRI, which showed an area of concern.  The biopsy was done using the MRI results and one positive core was in the area of concern I believe.  As to urination, I have noticed a weaker stream these last few years.  

    Yesterday my wife and I decided to shift my care to Yale.  I really like the suggestion of redo of the needle biopsies.  While I say active surveillance is probably the route, that just me be my wishful thinking.  Yale's philosophy at my stage is increasing the confidence level of my situation and let that drive the treatment plan. 

    As to your opinion/input; I find that you are not a doctor helpful.  You are ahead of me on this adventure and I appreciate your learnings and perspective.  I am steeped in the learning and research as we speak.  

    Enjoy your day!  Denis

  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,333 Member
    edited August 2017 #16
    .

    When a larger prostate places pressure on the urethea, more PSA is secreted, and so a higher PSA. 

    I forget to mention , for AS another indicator is PSA/prostate ratio...........you want this to be less than 0.15

    You mention life style..........heart healthy is prostate healthy...........I for one have stopped intake of dairy and and meat; others who post here follow a mediterranean diet.......exercise daily

    Some books:

    the china study...t. colin campbell

    DVD...FORKSoverKNIVES

    eat to live...joel .fuhrman, M.d.

    any book by ornish

    UCSF, nutrition and prostate cancer

    https://www.ucsfhealth.org/education/nutrition_and_prostate_cancer/

     

  • SubDenis
    SubDenis Member Posts: 130

    .

    When a larger prostate places pressure on the urethea, more PSA is secreted, and so a higher PSA. 

    I forget to mention , for AS another indicator is PSA/prostate ratio...........you want this to be less than 0.15

    You mention life style..........heart healthy is prostate healthy...........I for one have stopped intake of dairy and and meat; others who post here follow a mediterranean diet.......exercise daily

    Some books:

    the china study...t. colin campbell

    DVD...FORKSoverKNIVES

    eat to live...joel .fuhrman, M.d.

    any book by ornish

    UCSF, nutrition and prostate cancer

    https://www.ucsfhealth.org/education/nutrition_and_prostate_cancer/

     

    Thanks, I have been meatless

    Thanks, I have been meatless for 20 years.  I am reading klotz book.  I have read two others and have Thrive, as the next book.   I am in the process of getting my records to Yale.  Next step is confirmation of disease stage.  A bit frustrated with the slowness of the medical system.  Patience, not my strong suit!  Thanks, Denis

  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,333 Member
    edited August 2017 #18
    Thrive?

    -Dr. Google just told me that "Thrive" is a  weight loss system. Am I understanding right?  

    -With Prostate Cancer, which is very slow growing, you will have plenty of time to develop patience.

    -Research, research and research is very important. You are doing well. You may consider attending a local support group(s). USTOO is and organization that sponsors local support groups, worldwide. Google them.

  • SubDenis
    SubDenis Member Posts: 130

    Thrive?

    -Dr. Google just told me that "Thrive" is a  weight loss system. Am I understanding right?  

    -With Prostate Cancer, which is very slow growing, you will have plenty of time to develop patience.

    -Research, research and research is very important. You are doing well. You may consider attending a local support group(s). USTOO is and organization that sponsors local support groups, worldwide. Google them.

    Thanks, I have not started

    Thanks, I have not started the Thrive book yet but will soon. It is about nutrition, exercise and stress reduction, according to the forward.  

    Today I had a good round of golf with a good friend. I also chatted with another who is having his prostate removed this week.  And finally went for a long ride on my motorcycle.  My records have been sent to Yale, so hopefully can get that process going soon.  I am in a good place each day seems a little better.  I appreciate everyone's help!  Thanks, Denis

  • SubDenis
    SubDenis Member Posts: 130
    edited August 2017 #20
    Thrive book

    Read most of it last night.  No real surprises, fresh foods, fish and a boatload of supplements.  Not sure I trust an author who recommends supplements and then has a company that sells the supplements.  

    I am a pescatarian, don't eat meat.  I am pretty active, walk 18 holes of golf most days.  I am in good shape, maybe 10 pounds above ideal weight. I take a multivitamin and a D , but really am not sure they help anything but the manufacturer's bottom line.  I am hoping Yale will have a nutritionist to help me. 

  • Clevelandguy
    Clevelandguy Member Posts: 767 Member
    Do your homework

    Hi,

    I know it helped my piece of mind to do a lot of reasearch on Pca and also the treatment modes.  When I knew what the disease is and how to treat it, it helped me select the best course of treatment for me.  Each person is different on their choices and thats OK.  There are a lot of good treatments available to help us deal with the disease.  My Urologist told me that I would not die from Pca but I know it might still be a long journey.  Good luck & study,study,study, knowledge is key.  Livin six months at a time..........................

    Dave 3+4